Senate OKs Miller bills to improve treatment for substance use, ensure nursing homes’ solvency


STATE HOUSE – The Senate today approved two bills sponsored by Senate Health and Human Services Committee Chairman Joshua Miller to help protect patient care in Rhode Island.

The first bill (2024-S 2872) would help ensure that patients discharged from hospitals with mental health disorders, including substance abuse disorders, are discharged into the appropriate inpatient or outpatient setting quickly and efficiently. It would require that health plans cover residential or inpatient behavioral health treatment, and would prohibit prior authorization requirements for such treatment.

“Patients who visit the emergency room for a problem involving substance abuse shouldn’t be just sent home or discharged to the street if they need further recovery services. The chances of a patient actually getting the help they need and succeeding in their recovery are drastically reduced if they don’t start right away,” said Chairman Miller (D-Dist. 28, Cranston, Providence), who has sponsored numerous laws to help encourage rehabilitation and smooth the transition to it for patients who are discharged from hospitals. “The most effective way to help people with substance abuse disorders is to make it as easy as possible for them to get into recovery treatment. We need to do everything we can to eliminate any waiting and any administrative hoops they have to jump through. The quicker they walk in the door, the better chance they have at recovery, and the more likely they are to avert an overdose or other serious problem.”

This bill requires the Department of Health and the Department of Behavioral Health, Developmental Disabilities and Hospitals to develop and implement a plan to ensure that patients with mental health disorders, including substance use disorders, are discharged from hospitals into the appropriate inpatient or outpatient settings as quickly and efficiently as possible.

It requires that health plans provide coverage for necessary residential or inpatient services for the treatment of behavioral health disorders, and prohibits them from requiring preauthorization prior to a patient obtaining such services. Under the bill, the treatment facility would need to provide the health plan notification of admission, proof that an assessment was conducted, the initial treatment plan, and an estimated length of stay within 48 hours of admission. This bill also requires hospitals to incorporate consent for peer recovery specialist services into a comprehensive patient consent form.

The Senate also approved another bill sponsored by Chairman Miller to help protect nursing facilities’ financial solvency. The legislation (2024-S 2818) would require Department of Health approval before any licensed nursing home operator withdraws equity or transfers assets worth more than 3% of the facility’s total annual revenue for patient care services.

Existing law gives the Department of Health the ability to review health care facilities’ finances when there is a proposed transfer of ownership. Chairman Miller introduced the bill at department’s request to allow it to review finances when such a transfer takes place to recognize situations when facilities are struggling financially, and ensure that no owner of a nursing home can drain its resources at the expense of patient safety and care.

“This bill provides a guardrail that allows the Department of Health to know what is happening with nursing homes’ finances before there is a serious problem that jeopardizes patients’ health and safety, or the facility’s continued ability to serve the people of Rhode Island. It won’t stand in the way of successful for-profit nursing homes’ ability to make a profit; it will only allow the Department of Health to find out about financial solvency issues before they put patients at risk,” said Chairman Miller.

Both bills now go to the House of Representatives, where House Health and Human Services Committee Chairwoman Susan R. Donovan (D-Dist. 69, Bristol, Portsmouth) is sponsoring the patient discharge bill (2024-H 7901) and Rep. June S. Speakman (D-Dist. 68, Warren, Bristol) is sponsoring the nursing homes bill (2024-H 7819).